Racial and ethnic differences in the association of social cohesion and social capital with HIV testing.

HIV testing rates vary by race and ethnicity. Whether social capital indicators are related to HIV testing and whether these associations differ by race or ethnicity is unknown. Multivariable analysis was used to examine whether social capital (collective engagement and civic and social participation), including social cohesion (trust in neighbors, neighbors willing to help, feelings of belongingness) were associated with testing for HIV in the past 12 months. Participants were white, Black or African American, and Hispanic/Latino adults ages 18 to 44 (N = 2823) from the general population, in Philadelphia, PA who participated in the Southeastern Pennsylvania Household Health Surveys 2010 and 2012. Overall HIV testing in this sample was 42%, and was higher among women, and Black compared to white people. Mean social capital scores were significantly highest among whites. Greater trust in neighbors was associated with lower odds of testing for HIV (adjusted Odds Ratio[aOR]:0.61, 95% CI = 0.49-0.74), and this relationship varied by race/ethnicity, with stronger inverse associations among Hispanic/Latino (aOR = 0.43, p < 0.001) and white adults (aOR = 0.50, p < -0.001) than among Black adults (aOR = 0.75, p < 0.05). Greater neighborhood belongingness (aOR = 1.31, 95% CI = 1.11-1.54) and working together to improve the neighborhood (aOR = 1.33, 95%CI = 1.03-1.73) were associated with higher odds of testing for HIV. Different indicators of social capital were associated with higher as well as lower odds of testing for HIV. These patterns did not vary statistically by race or ethnicity. HIV testing prevention interventions will need to address social capital in design and implementation strategies.

Social Media & PrEP: A Systematic Review of Social Media Campaigns to Increase PrEP Awareness & Uptake Among Young Black and Latinx MSM and Women.

Pre-exposure prophylaxis (PrEP) has been shown to be highly effective at reducing the risk of HIV. Despite efforts to employ various social marketing strategies to promote PrEP among young people at greater risk for HIV, PrEP awareness and uptake remain low. We conducted a comprehensive review of current literature that presents or evaluates the use of social media and/or specific communication campaigns to increase PrEP awareness among young Black and Latinx men who have sex with men (MSM) and women. Eight articles met the inclusion criteria for the final analysis. The most used platforms included Facebook, Instagram, and custom mobile applications. Social media is a dynamic and promising tool that may be used to increase PrEP awareness, uptake, and adherence among young Black and Latinx MSM and women.

RESUMEN: Se ha demostrado que el profilaxis preexposición (PrEP) es muy eficazo para reducir el riesgo de contraer el VIH/SIDA. A pesar de los esfuerzos empleando diversas estrategias sociales de marketing para promover el PrEP entre los jóvenes que tienen mayor riesgo de contraer el VIH/SIDA, el conocimiento y la aceptación del PrEP siguen siendo bajas. Realizamos una revisión exhaustiva de la literatura actual que presenta o evalúa el uso de las redes sociales e campañas de comunicación específicamente para aumentar el conocimiento sobre el PrEP entre los jóvenes hombres que tienen relaciones sexuales con hombres (HSH) y las mujeres de raza negra y latinx. Ocho artículos satisfacieron los criterios de inclusión para el análisis final. Las plataformas más utilizadas incluyeron Facebook, Instagram y aplicaciones móviles personalizadas. Las redes sociales demuestran ser un instrumento dinámico y prometedor que se puede utilizar para aumentar el conocimiento, la aceptación y la adherencia del PrEP entre los HSH y las mujeres jóvenes de raza negra y latinx.

Interaction of Religion/Spirituality With Internalized HIV Stigma, Depression, Alcohol Use, and Sexual Risk Among Black Men Who Have Sex With Men: The 6 City HPTN 061 Study.

BACKGROUND: Black men who have sex with men (BMSM) remain at highest risk for HIV in the United States. Internalized HIV stigma and depression contribute to substance use and condomless anal intercourse (CAI). Religion and spirituality (R/S) are associated with decreased HIV-related risk behaviors for some groups, but their impact among BMSM is uncertain. We investigated the main and moderating roles of R/S on pathways from internalized HIV stigma to CAI while under the influence of drugs. METHODS: We used baseline data from 1511 BMSM from the HIV Prevention Trials Network (HPTN) 061 study to examine the associations between internalized HIV stigma, depressive symptoms, alcohol use, and CAI while under the influence of drugs, adjusting for covariates in generalized structural equation models. We then tested whether R/S moderated the association between (1) internalized HIV stigma and depressive symptoms, (2) depressive symptoms and alcohol use, and (3) alcohol use and CAI while under the influence of drugs. RESULTS: Spiritual beliefs [F(1,2) = 9.99, P < 0.001], spiritual activities [F(1,2) = 9.99, P < 0.001], and religious attendance [F(1,2) = 9.99, P < 0.001] moderated the pathway between internalized HIV stigma and depressive symptoms. As internalized HIV stigma increased, those with lower spiritual activity scores experienced significantly higher increases in depressive symptoms compared with those with higher spiritual activity scores whose depressive symptom scores remained unchanged [stigma × spiritual activities B = -0.18 (SE = 0.07), P < 0.001]. CONCLUSIONS: Religion and spirituality were protective against CAI among BMSM. Future intervention research should explore ways to incorporate religious and/or spiritual activities to reduce internalized HIV stigma as one way to reduce depressive symptoms among BMSM.